Pain management最新文献

{"title":"Verbal framing, rather than measured cognitive-affective variables, is associated with short-term outcomes after spinal manipulation: a secondary analysis of a randomized controlled trial.","authors":"Kamil Zaworski, Joanna Baj-Korpak, Małgorzata Tokarska-Rodak, Ewa Plażuk, Andżelika Nazarewicz, Giacomo Rossettini","doi":"10.1080/17581869.2026.2638403","DOIUrl":"10.1080/17581869.2026.2638403","url":null,"abstract":"<p><strong>Background: </strong>Pre-treatment communication may influence short-term responses to spinal manipulation. This secondary analysis examined associations between expectations, attitude toward manual therapy, expectation fulfillment, and pain intensity (NPRS-11) and lumbar pressure pain threshold (PPT) across verbal framings.</p><p><strong>Methods: </strong>Sixty-six young adults with chronic nonspecific low back pain were randomized to positive, neutral, or negative verbal framing delivered before lumbar spinal manipulation. NPRS-11 and lumbar PPT (L3-L5) were assessed at baseline (t0), immediately post-intervention (t1), and 24 hours post-intervention (t2). Group-specific correlation analyses and multiple linear regression were performed.</p><p><strong>Results: </strong>Associations were sparse and inconsistent. Expectation fulfillment assessed at t2 showed no consistent associations with NPRS-11 or PPT at t1 or t2. In the positive group, higher expectations correlated with higher immediate PPT at t1 L4 (<i>r</i> = 0.47) and L5 (<i>r</i> = 0.43), and a more favorable attitude correlated with lower NPRS-11 at t2 (<i>r</i> =  -0.45). In regression analysis predicting NPRS-11 at t2, only verbal framing group was retained (adjusted R² = 0.26; <i>p</i> < 0.001): negative framing predicted higher pain (β = 0.35), whereas positive framing predicted lower pain (β =  -0.26).</p><p><strong>Conclusions: </strong>Short-term NPRS-11 and lumbar PPT were associated with verbal framing rather than with cognitive-affective variables.</p><p><strong>Clinical trial registration: </strong>The ClinicalTrial.gov identifier is NCT06537739.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"461-470"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercostal nerve radiofrequency ablation for slipping rib syndrome: a case report.","authors":"Greta Niemela, Erina Fujino, Rohan Jotwani, Tiffany Lin","doi":"10.1080/17581869.2026.2624365","DOIUrl":"10.1080/17581869.2026.2624365","url":null,"abstract":"<p><p>Slipping rib syndrome (SRS) is an underdiagnosed condition causing chronic debilitating thoracic wall pain due to hypermobility of costal cartilage and irritation of intercostal nerves. Conservative management includes analgesics and intercostal nerve blocks. When these measures fail, surgical rib fixation is considered. This case is the first reported successful use of intercostal nerve radiofrequency ablation (RFA) as a preoperative bridge in the management of SRS. We report a case of a 25-year-old woman with hypermobile Ehlers-Danlos Syndrome and slipping rib syndrome who developed recurrent rib fractures and chronic chest wall pain. After limited relief with opioids and intercostal nerve blocks, she underwent bilateral T7-T10 intercostal nerve RFA, resulting in complete pain resolution and opioid tapering. She later proceeded with bilateral rib fixation and remained pain-free postoperatively. Intercostal nerve RFA offers a promising minimally invasive treatment for patients with chronic intercostal neuralgia due to SRS, particularly in high-risk surgical patients. This case also supports the potential value of interdisciplinary collaboration between pain specialists and thoracic surgeons to optimize care for patients undergoing thoracic surgeries.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"391-395"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging technologies in acute pain management.","authors":"Vendhan Ramanujam, Haley Warzecha, Yash Shah, Bijan Moazezi, Benjamin Rapsas, Kelsey Sawyer","doi":"10.1080/17581869.2026.2631514","DOIUrl":"10.1080/17581869.2026.2631514","url":null,"abstract":"<p><p>Acute pain is a prevalent clinical concern that impacts millions worldwide and often initiates opioid use. Despite advances in multimodal analgesia, challenges such as opioid dependency, under-treatment, and patient heterogeneity persist. This narrative review aims to present recent evidence on emerging technologies in acute pain management, covering innovations in diagnostics, therapeutics, and drug delivery systems. We searched PubMed and Embase databases and included studies from 2015 to 2025 that presented positive evidence of the investigation of these technologies. The review identifies a wide range of emerging tools and interventions, including digital pain assessment scales, wearable biosensors, virtual reality, hypnosis, music therapy, and multimodal distraction. Pharmacological innovations such as sublingual sufentanil, liposomal bupivacaine, Nav 1.8 inhibitors, cebranopadol, and co-crystals of tramadol-celecoxib also show promise. Novel delivery systems - oral patient-controlled analgesics devices, transdermal iontophoretic fentanyl, and bioresorbable nerve stimulators - further enhance individualized pain control. Technological advancements are expanding the toolkit for acute pain management, offering non-opioid, patient-centered, and precision-based alternatives. However, further large-scale and longitudinal studies are required to validate their efficacy, safety, and cost-effectiveness across diverse patient populations and clinical settings.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"507-521"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the capsule: an integrated perspective on the wide world of frozen shoulder. A collaborative viewpoint.","authors":"Fabrizio Brindisino, Michel Gcam Mertens, Paul Salamh, Santiago Navarro Ledesma, Dina Hamed Hamed, Filip Struyf, Filip Vanhoenacker, Pablo Oscar Policastro, Paula Rezende Camargo, Giacomo Rossettini","doi":"10.1080/17581869.2026.2636725","DOIUrl":"10.1080/17581869.2026.2636725","url":null,"abstract":"<p><strong>Background: </strong>Frozen Shoulder (FS) is a highly disabling glenohumeral condition marked by severe pain and restricted active and passive motion, typically without significant radiological changes. While conventionally viewed as a self-limiting and idiopathic disorder, recovery is often incomplete, suggesting that peripheral-only interventions are insufficient.</p><p><strong>Objective: </strong>This manuscript reviews the contemporary understanding of FS etiopathogenesis, clarifying the underlying pain processing mechanisms, metabolic patterns, and psychological domains. Evidence about diagnostic tests and imaging for FS, and updated treatment strategies were also discussed.</p><p><strong>Key findings: </strong>The latest evidence suggests FS is the musculoskeletal manifestation of systemic metabolic, inflammatory, and neuroendocrine dysregulation. Pain mechanisms extend beyond the periphery, showing links to sensitization and possible central involvement, though further clarity is needed. Moreover, FS significantly impacts mood, beliefs, and social well-being. Imaging remains a tool for diagnosis and differential ruling, and treatment should be \"tailorized\" from biopsychosocial perspective. Individualization involves the understanding of the individual's personal history, clinical characteristics, context, and goals in combination with tissue irritability.</p><p><strong>Conclusion: </strong>Clinicians must move beyond solely addressing FS as a \"local\" pathology. Modern research indicates that FS is a complex pathology involving an inflammatory phase followed by a fibrotic shift, fueled by metabolic, inflammatory, neuroendocrine, and psychological factors.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"487-506"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter in reply: ''Dosing trends for buprenorphine buccal film: a step in the wrong direction''.","authors":"Vladimir Zah, Filip Stanicic, Dimitrije Grbic","doi":"10.1080/17581869.2025.2591466","DOIUrl":"10.1080/17581869.2025.2591466","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"389-390"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145605721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of multidisciplinary open-label treatment in patients with persistent post-traumatic headache at two tertiary headache centers.","authors":"Sarah Wasfi Abd-Albaqi, Bjarne Kjeldgaard Madsen, Simon Møller Salomon, Nina Caspersen, Lotte Skytte Krøll, Kirsten Larsen, Tatiana Danielsen, Sidsel Thorup Thomsen, Sasha Revelius Gaj Baatz, Louise Schlosser Mose, Faisal Mohammad Amin, Henrik Winther Schytz","doi":"10.1080/17581869.2026.2638405","DOIUrl":"10.1080/17581869.2026.2638405","url":null,"abstract":"<p><strong>Background: </strong>Persistent post-traumatic headache (PTH) is a frequent and disabling sequela of mild traumatic brain injury. This proof-of-concept study investigated whether a one-year multidisciplinary intervention could reduce PTH and other post-concussion symptoms in patients treated at the Danish Headache Center and the Headache Center in Southwest Jutland.</p><p><strong>Methods: </strong>This prospective, non-randomized cohort study included consultations with a doctor, nurse, physiotherapist, and psychologist, and offered pharmacological treatment with candesartan, amitriptyline, or gabapentin. Data were collected before and after the intervention using medical records and electronic questionnaires, including the Rivermead Post-Concussion Symptoms Questionnaire, Hospital Anxiety and Depression Scale (HADS), and Insomnia Severity Index (ISI).</p><p><strong>Results: </strong>Fifty-eight patients with PTH (mean duration 36 months) were enrolled between August 2021 and February 2023. Headache frequency decreased by 1.7 days per month (<i>p</i> = 0.044). There were no significant changes in acute medication use (<i>p</i> = 0.965), Rivermead score (<i>p</i> = 0.169), HADS-anxiety (<i>p</i> = 0.792), HADS-depression (<i>p</i> = 0.898), ISI (<i>p</i> = 0.138), physical activity (<i>p</i> = 0.071), or self-rated health (<i>p</i> = 0.598). Candesartan, amitriptyline, and gabapentin were reported effective by 28%, 6.5%, and 22% of users, respectively.</p><p><strong>Conclusion: </strong>A comprehensive multidisciplinary program did not produce clinically meaningful improvement in headache or associated symptoms, although patient satisfaction remained high. Further research is needed to improve treatment strategies.<b>Clinical trial registration</b>: The ClinicalTrials.gov identifier is NCT05328635.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"471-478"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-frequency nerve block treatment for chronic post-amputation pain over 12 months: plain language summary of the QUEST trial.","authors":"Leonardo Kapural, Jeff Pullen, Nicholas J Hargus","doi":"10.1080/17581869.2026.2653162","DOIUrl":"https://doi.org/10.1080/17581869.2026.2653162","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-18"},"PeriodicalIF":1.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BurstDR and multi-area Burst DR spinal cord stimulation for the treatment of chronic pain: \"less is more\".","authors":"Steven Falowski, Dirk DeRidder","doi":"10.1080/17581869.2026.2663948","DOIUrl":"https://doi.org/10.1080/17581869.2026.2663948","url":null,"abstract":"<p><strong>Introduction: </strong>Neuromodulation treatments are a well-established therapy for chronic pain patients. BurstDR is a novel spinal cord stimulation platform rooted in clinical and scientific data.</p><p><strong>Body: </strong>It not only activates the lateral and descending pathways which are observed with traditional tonic stimulation but is able to activate the medial pathways and therefore effect the emotional and cognitive components of pain. It has been shown to be different than other \"burst\" platforms on the market which are intermittent tonic stimulation. It is a highly energy-efficient stimulation paradigm that operates on a \"less is more\" paradigm.</p><p><strong>Evidence: </strong>BurstDR^TM SCS has level 1A evidence supporting its use, multiple systematic reviews, and numerous placebo-controlled trials. Multi- area Burst DR/Flexburst360^TM has 6-month prospective data, 4-year real-world data, and trial data in addition to established scientific evidence with human electrophysiological recordings.</p><p><strong>Conclusion: </strong>The distinct characteristics of the BurstDR and multi-area Burst DR platforms not only deliver consistent pain relief but also lend itself to improving painfulness, suffering, disability, quality of life, pain intensity, and pain interference. The high levels of patient global impression of change demonstrate the considerable impact on the patients' lives.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-15"},"PeriodicalIF":1.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the efficacy of self-myofascial release technique versus muscle energy technique in sacroiliac pain management: a clinical trial protocol.","authors":"Rama Taneja, Amita Aggarwal","doi":"10.1080/17581869.2026.2664769","DOIUrl":"https://doi.org/10.1080/17581869.2026.2664769","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to compare self-myofascial release with the muscle energy technique for sacroiliac pain.</p><p><strong>Methodology: </strong>Forty patients with sacroiliac pain who fulfil the eligibility criteria and provide written informed consent will be recruited from a tertiary care hospital for a two-group pre-post experimental study design. After noting the demographic details, subjects will be randomized using a computerized randomization method. Group A will receive the self-myofascial release technique, and Group B will receive the Muscle Energy Technique. Conventional treatment will also be given in both groups. Both interventions will be administered for a period of 2 weeks. Primary Outcome measures will include pain (Visual Analog scale), pressure-pain threshold (Pressure Algometer), and Function. The Secondary Outcome includes Leg Length Discrepancy and Quality of life (EuroQol-5 Dimension). All outcomes will be recorded at baseline, at the end of 2 weeks and after 4 weeks.</p><p><strong>Conclusion and relevance: </strong>This trial will expand our understanding of the use of the self-myofascial release technique and Muscle Energy Technique in treating patients with sacroiliac pain, and inform the development of a tailored protocol for manual therapy interventions in these patient care settings.</p><p><strong>Clinical trial registration: </strong>The www.ctri.nic.in/Clinicaltrials identifier is CTRI/2025/07/090693 (Version 1.0-10 July 2025).</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does rimegepant prevent migraine attacks in people who have not found other treatments taken by mouth (orally) to work well? A plain language summary of clinical study findings.","authors":"Patricia Pozo-Rosich, José Antonio Gien López, Pawel Lisewski, Ayşe Neslihan Aslan, Harpreet Seehra, Alexandra Thiry, Lucy Abraham, Luz M Ramirez, Robert Fountaine, Terence Fullerton","doi":"10.1080/17581869.2026.2646702","DOIUrl":"https://doi.org/10.1080/17581869.2026.2646702","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}